Provider Demographics
NPI:1861507758
Name:LU, ZHEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ZHEN
Middle Name:
Last Name:LU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RICHARD
Other - Middle Name:
Other - Last Name:LU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2115 N TUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92865-3745
Mailing Address - Country:US
Mailing Address - Phone:239-287-9043
Mailing Address - Fax:
Practice Address - Street 1:2115 N TUSTIN ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92865-3745
Practice Address - Country:US
Practice Address - Phone:239-287-9043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA227044207Q00000X
CAA106148207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AJ809ZMedicare PIN